Ally Medical Group, P.a. P.C.

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

Legal business name

ALLY MEDICAL GROUP, P.A. P.C.

Practice address

1410 Spring Hill Rd Ste 305
MC Lean, VA 22102-3020

Phone

(240) 342-2666

NPI assigned

Aug 29, 2024

Last updated

Aug 29, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lorraine Kabakama Beraho, MD

Title

Director

Phone

(301) 529-4927

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1710711973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 SPRING HILL RD STE 305",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 SPRING HILL RD STE 305",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023020",
            "telephone_number": "240-342-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLY MEDICAL GROUP, P.A. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "BERAHO",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_middle_name": "KABAKAMA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-529-4927",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental - Behavioral Pediatrics Physician in McLean, VA
• Providers in McLean, VA by specialty
• Developmental - Behavioral Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.